Individual
JENNIFER KWAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
391 WEST ST, KEENE, NH 03431-2409
(603) 357-0677
Mailing address
1 LEE JOY LN, SALEM, NH 03079-2591
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
05071
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2023
Last updated
09/09/2024
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